Trauma Recovery

Recovery is the primary goal for those who have experienced trauma, their families, and their care providers. Recovery does not necessarily mean complete freedom from post-traumatic effects. Rather, it is an individual experience that will look and be different for everyone. In general, recovery is the ability to live in the present without being overwhelmed by the thoughts and feelings of the past.

In a trauma-informed system, it is acknowledged that everyone plays a role in supporting recovery, from the person at reception to the CEO.

What May Help

It is impossible to sweep the world clean of triggers. There will always be difficult problems to solve, events that are unsettling and experiences that are unpleasant. It is a much better strategy to enhance our ability to cope. We now know that even deep patterns of neural firing can be changed through the ability of the brain to change itself (Davidson, 2003).

Through the nurturing of healthy relationships, attending to basic physical needs (i.e., sleep and nutrition), having adequate housing and food security, people have a greater opportunity to engage in trauma recovery. The mind, body and spirit will respond to these positive factors, which maximizes the potential for healing.

In addition, the practice of mindfulness can also play a significant role in trauma recovery by helping to restructure parts of the brain that have been the most compromised by trauma. Mindfulness is paying attention in the present moment to body sensations, emotions and thoughts without judgment (Williams et al., 2007). Mindfulness is a skill based on thousands of years of practice in various meditative traditions. The most popular modern versions are Mindfulness Based Stress Reduction, yoga, and qi gong.

Safe relationships and the development of mind/body practices calm the limbic system. Recent studies that look at changes in the brains of people who have been practicing meditation, even for a short time, show that their limbic systems are less reactive and the neural connections between the prefrontal cortex (thinking brain) and the limbic area (reactive brain) had increased (Davidson, 2012). These changes show that meditators are more likely to pause before reacting and, when stressed, choose a wiser course of action.

Other studies have shown that cognitive behavioural therapy combined with mindfulness practices can help prevent a relapse in people prone to clinical depression (Williams et al., 2007), obsessive compulsive disorder (Schwartz, 1996), and addictions (Marlatt, 2010).

Not all mindful practices involve sitting still. Bessel van der Kolk’s team at his centre for people impacted by trauma in Massachusetts showed that women with “treatment resistant” PTSD improved after participating in several weeks of yoga. Almost half of them no longer had the symptom requirements for a diagnosis of PTSD (see yoga article at www.traumacenter.org ). While these are early days, the emerging literature would suggest that there are many ways to heal from trauma.

Important Aspects of Trauma Recovery

Safety and Stabilization

The central task of recovery is safety. Clients may feel they lack control over their emotions and other issues that stem from the unresolved trauma. Helping clients to realize what areas of their life need to be stabilized, and how that will be accomplished, will help the client move toward recovery. For example:

A person who has experienced trauma may struggle to regulate difficult emotions in everyday life, which they might not necessarily associate directly to the trauma.

A service provider can help the client learn to regulate these emotions.

They work together as a team to stabilize the emotions so the individual who has experienced trauma can move on with the recovery process. This process takes time and varies from person to person.

Some people who experienced trauma, particularly complex trauma, find that speaking about their experience or about the impact of their experience emotionally overwhelming. Recently, both therapists and researchers have been exploring nonverbal ways to foster emotional regulation. Several studies have suggested that Mindfulness Based Stress Reduction (MBSR) groups and the use of acupuncture for clients with PTSD reduce negative emotions and promote a calmer appraisal of life situations (Hollifield, 2007; Davidson et al., 2003). These practices work well with more traditional talk therapies and allow greater stability throughout recovery. Auricular acupuncture has the added advantage of reducing cravings for alcohol and drugs, as well as promoting better sleep and clearer thinking among clients who receive it regularly (Stuyt, 2005). It is also well suited for supporting work with refugees and immigrants in that it is nonverbal and closer to the methods of traditional medicine found in their own cultures.

Remembrance and Mourning

When clients feel stable, the task shifts to recounting the trauma, putting words and emotions to it, and making meaning of it. This process is usually undertaken with a counsellor or therapist in individual and/or group counselling. It might not require or be necessary to spend a lot of time in this phase. It is necessary, however, to continue to attend to safety during this phase. Attending to and establishing safety allows the client to move through this phase in a way that integrates the story of the trauma, rather than responding to it from a fight, flight and freeze response.

Pacing and timing are also crucial, and the point is neither to “re-live” nor avoid the trauma. This phase also includes exploring the losses associated with the trauma, and providing space for the client to grieve and experience the sadness associated with these losses.

Reconnection

The final stage of recovery involves redefining oneself in the context of meaningful relationships. When they are able to see the things that happened to them and understand that those events do not determine who they are, many people who have experienced trauma are able to gain a different perspective and meaning of the traumatic experiences. The trauma is no longer the organizing principle of their lives. It becomes part of their story, but they are not living in it or from it.

In many instances, people who have experienced trauma find a mission through which they can continue to heal and grow, such as talking to youth or peer mentoring. Successful resolution of the effects of trauma is a powerful testament to the resiliency of the human spirit.

Other Aspects of Trauma Recovery

Assist the client in connecting with services that are central to recovery, such as health and mental health services, addictions services, therapeutic services, crisis services, culturally appropriate/relevant services, and traditional healing services.

Partner with the client as they define what recovery means to them.

Consider the client’s cultural context and include social supports that help them connect to the community.

Encourage and assist the client in connecting in a meaningful way with themselves, safe family members, friends, culture and community.

Assist clients in identifying activities that would provide a sense of purpose and meaning

Being a trauma survivor means that I have remarkable coping skills, intuition, and resiliency. Contrary to what many (including other survivors) may think, trauma survivors can be, and often are, highly functioning individuals. Even though we sometimes have an inability to care for ourselves and make safe choices, this does not mean we are strangers to ourselves and do not know our needs.